Patricia Ryan (Kildare South, Sinn Fein) | Oireachtas source

I welcome the opportunity to speak on this Bill. It is an issue that is dealt with in a similar Bill around this time every year to provide for risk equalisation. Risk equalisation is a mechanism designed to give effect to the objective of a community-rated health insurance market where customers pay the same premium for the same health insurance plan, regardless of age, gender or health status. The Health Insurance Acts provided for a risk equalisation scheme in 2013. Under the scheme insurers receive risk equalisation credits to compensate for the additional cost of insuring less healthy or older members.

Some 45% of the population is covered by private health insurance. Those people pay over €2.5 billion per year in premiums. The Irish market is dominated by three main players. The statutory corporation, VHI, has a 51% market share, Laya has 28% and Irish Life Health has 21%. For many workers and families, health insurance is an unaffordable luxury. They make great sacrifices to pay for it, hoping they will not have to use it. Many people with health insurance scrimp and save to make up the consultant fees necessary to start the journey towards getting a procedure done under their health insurance. The only reason to pay is our health system. It is so bad that people fear the long waiting lists in public hospitals.

There are hundreds of thousands of people on long waiting lists. The Government has no credible plan to address this. We need to fix the imbalance in healthcare in order to remove private healthcare from our public hospitals and our public healthcare system. Sláintecare is on life support and needs a major focus from Government to keep it going. We need to move away from a two-tier health system. There are many people falling through the cracks and earning too much to qualify for a medical card and too little to afford health insurance. Ability to pay should have no bearing on how you are treated by the healthcare system. People are languishing on waiting lists and getting sicker, while those with health insurance are fast-tracked to the front of the queue. In some cases, they are treated by the same doctors and even in the same hospitals. For those who have to wait their mental health is suffering and in some cases their life expectancy will be lowered. That is simply not good enough.

Health insurance exploits a failed public health system, a public health system that Government policy has been trying to kill off for years because it favours a private health system. Treating our health service as a commodity is hurting those who need it the most, namely, the elderly and the working poor. My office is inundated with people who are in great pain and waiting for badly needed treatment. If delivered, this treatment would be life-changing. It is a disgrace that people have to go to their local Deputies to get letters sent to the Minister to wait weeks for a reply because the issue is brushed off to the HSE. The Minister of State needs to take responsibility for the mess and sort it out urgently.

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